Analyze and reflect on the decision-making process (systematic, collaborative, and observation) which change therapeutic regime of Mr S. into Insulin instead of a metformin-based regime.

1. Essay question

“An Effective Practitioner is tasked with making clinical decisions with patients and clients many times during their health and care journey” (NES, 2015).

Explore a recent decision that was made with one of your patients: discuss the process of the clinical decision making and evaluate the effectiveness of the decision.

Formative copy
2. My Clinical decision-making;
Change therapeutic regime of Mr S. into Insulin instead of a metformin-based regime.
3. My essay plan
This essay plan wrote it by using previous essay which I will attached to you can use it as a guide
 Introduction (approximately 500 words)
 Due to confidentiality policies patient will introduced with Mr. S. (Nursing and Midwifery Council guidelines, 2010).
 Mr. S. 80 years old diagnosed with Type 2 diabetic and faced difficult for complying with his treatment regime (metformin). Moreover, recurrently patient missed his appointment and careless with regard to his dietary compliance.
4. Analyze and reflect on the decision-making process (systematic, collaborative, and observation) which change therapeutic regime of Mr S. into Insulin instead of a metformin-based regime.
 Concepts of CDM (identify key policy drivers and led to the development of an evidence-based culture with a primary focus on the quality of the decisions made by the healthcare professionals). (Montanari & Nelson, 2013).
 Please give a look to my tutor feedback for this section and improve it
 Main body (approximately 2000 words)

 Concepts of CDM (identify key policy drivers and led to the development of an evidence-based culture with a primary focus on the quality of the decisions made by the healthcare professionals). (Montanari & Nelson, 2013).
 Decision-making pathways based on a number of universally accepted premises, which can condensed into four main concepts. (Nursing Board of Australia, 2010)
 A comprehensive holistic assessment of both the client and their expressed and perceived needs. (Larsen et al, 2014).
 Issues of accountability are also considered central to the decision-making process.
 Collaboration with other members of the multidisciplinary treatment team. (Cadzow et al, 2013).
 Appropriate evidence-based care pathways of decision-making process.
 Please give a look to my tutor feedback for this section and improve it.
 Conclusion (approximately 500 words)
 Please give a look to my tutor feedback for this section.
 References
Montanari, I. & Nelson, K. 2013, Social service decline and convergence: How does Healthcare fare? Journal of European Social Policy, Feb 23: 102 – 116.
Nursing Board of Australia (NBA). 2010,. Final Report on the implementation of a scope of practice decision-making framework. Macmillan publishing: Sydney.
Larsen, N., Gray, M. & Eckstein, D. 2014, The Relationship decision-making Box: A Questionnaire for Exploring the decision-making process. The Family Journal, Apr 22: 222 – 225.
Cadzow, R B., Craig, M., Rowe, J. & Kahn, L S. 2013, transforming multidisciplinary treatment team Members Into Diabetes Cultural Health Brokers: The Neighborhood Health Talker Project. The Diabetes Educator, Jan 39: 100 – 108.
Can you please use this reference called (Standing, 2011) in different stages of the essay which about CDM and clinical judgement are integral processes in nursing?

5. My tutor feedback
Thank you for your submitting your essay plan for this module. In general this was a very good essay plan which followed a structured and well thought out approach.
1) Introduction Section: Your introduction does introduce your patient, clinical environment and makes reference to some of the background surrounding the decisions in relation to introduction of insulin therapy in patient’s management plan. You clearly state the decision you are focussing on from the onset of the essay – this was good! In general you set the scene well here – well done! You have made reference to confidentiality and anonymity issues. Remember to say they you have set a pseudonym for your selected patient.
At this stage in your plan you intend to provide some brief exploration and discussion of what decision making is, the key concepts involved, and the nurses’ accountability for effective decision making (supported with literature). Again this is good and I would continue with this plan. You should aim to address some of the main policies/protocols/Drivers etc. which underpin your selected decision (remember to review any clinical guidelines such as SIGN which underpin the decsion). You should allocate around 500 words for your introduction section.
2) Main Body: In your main body you have identified appropriate content to explore at this stage. Again this was well considered and researched! This was good and related well to your chosen topic. You can continue to focus on developing this in your summative. Whilst this is appropriate remember and support with literature and to relate these concepts to the decision made and the decision making process which you are focussing on in your essay .
Key concepts which could be developed and explored further within your essay in relation to your identified decision could include:
• Types of decision involved(example systematic decision making)/Clinical Judgement
• Nurses Accountability for nurses decisions
• Cores skills in decision making– critical thinking, communication, evidence based practice/evidence based decision making, Collaboration and team work
• Decision making process/collaborative/shared decision making/Patient Centred Care
• Prioritising decisions in delivering care
• Factors affecting decision making
• Reflective judgement and decision making
• Evaluation of outcome ( I would advise inclusion of this concept in your summative and you have planned to address this)
• You should support your main themes you have selected with that of the literature

It is of course not possible to explore all the key concepts above. These are only included for ideas and guidance. The concepts you choose to focus on within your main body will of course be determined by the selected topic/decision identified in your essay. You should allocate around 2000 words to the main body section of the essay.
3) Conclusion Section: This can be developed as your essay progresses. In your conclusion section you should aim to summarise your findings and learning.
In your conclusion (if not already addressed) It may be a good idea to summarise on the decision making process you have described as well as the actual outcome of the decision made. For example what did you learn from exploring the decision made? What would you do differently? What could be improved?
What would you recommend for future implications for the development of your skills in this area?
You should allocate around 500 words to this section of the essay.
4) Literature & Referencing: You have included a reasonable range of reading and underpinning references to support your discussions at this stage and this was good! You should plan to continue to search the literature and widen the breadth and scope of your underpinning reading and refer to quality sources. You have utilised mostly accurate citation methods – well done! However, whilst you provide wider reading you haven’t actually referred to these sources in-text? As such you can continue to integrate your reading with your essay discussions for your summative submission. Please review your citation methods. Article titles in journals are usually presented in inverted commas and the journal title in italics….Please see your school referencing guide
5) General Guidance for Essay (Provided for all students in the module group)
This essay requires you to identify a recent decision that was made with one of your patients. You are then required to explore the concept and process of decision making, referring throughout to current published evidence from good quality sources to support and critically analyse the decision made and the outcome of that decision.
Keep a clear focus: Don’t lose sight of the fact that this essay is about decision making and the decision making process (in relation to your chosen topic). As such, try to avoid overly narrating the nursing care that was provided for the patient or any adverse events which may have occurred. Again try and avoid simply describing how the patient was cared for. Remember this is not a reflective essay and as such you should be focussing on critically discussing the decision made, the decision making processes and evaluating the effectiveness of the decision.
Improving Critical Writing: Try to use and refer to multiple authors who share /support similar viewpoints and perspectives to that which you are discussing. Using multiple authors who “support” viewpoints and perspectives from the literature helps evidence wider reading and a more critical approach to writing.
Similarly, try to refer to multiple authors who challenge/disagree/refute/ or provide alternative viewpoints and perspectives to the points which you are discussing. Again using authors who refute or challenge viewpoints helps you to “compare & contrast” views from the literature more effectively.
Referencing and Reading: I would advise that you include key module reading within your essay and develop this by exploring the literature further.
Please ensure you read widely and source good quality literature to support your essay/discussions/content and adhere to the school referencing guide when developing your summative essay.
References by Harvard style and most of the references should be from UK base and recent and related to the field.

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